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WHAT IS 
PSYCHOANALYSIS: 


BY 
ISADOR H. CORIAT, M.D. 


First Assistant Visiting Physician for Diseases of 
the Nervous System, Boston City Hospital. 
Author of ‘‘Abnormal Psychology,”’ etc. 





NEW YORK 
MOFFAT, YARD AND COMPANY 
1917 


CopyRriGutT, 1917, BY 
MOFFAT, YARD & COMPANY 


Published, March, 1917 


“THE FUTURE I MAY FACE NOW 
I HAVE PROVED THE PAST.” 


Browning's “Rabbi Ben Ezra” 


iy 


eo 








age o 
- 


INTRODUCTION 


The origin and purpose of this book may 
be stated in a few words. From time to time 
physicians, clergymen, social workers and 
laymen have made certain enquiries concern- 
ing psychoanalysis, with particular reference 
to its aim and purpose and its field of use- 
fulness as a therapeutic procedure. These 
questions were recorded and the answers 
planned, partly on the basis of the theory of 
psychoanalysis and partly in the meeting of 
certain objections and criticisms which were 
made at the time the questions were an- 
swered. Much of this data is incorporated 
in the present little volume. ae 

The answers to these questions, while ex- 
plaining psychoanalysis, have at the same 


time provided suggestions for mental hy- 
”Y 


Introduction © 


giene and character formation. It is hoped | 
that this volume will answer satisfactorily 
the various enquiries which puzzle people in 
a scientific field so new and epoch-making 
and so little understood as that of psycho- 
analysis. ‘The nature of the book renders a 
little repetition necessary and unavoidable. 

The neuroses are the most distressing and 
frequent of human ills, and to a greater de- 
gree than physical diseases, they lead to so- 
cial inefficiency. In severe bodily disorders, 
the patient can utilize his inner resources for 
compensation and consolation, but in the 
neuroses he is robbed of these resources, 
since the mind is torn by emotional conflicts. — 
It is here that psychoanalysis is most effica- 
cious, because it brings relief from within, 
from the inner resources of the sufferer. — 
Psychoanalysis is recognized to-day as the - 
most important advance in methods of a ra- 
tional and scientific psychotherapy. It is 
applicable to all nervous disorders of mental 

8 


j 


Introduction 


origin which make up so large a part of the 
practise of medicine. 

This volume does not profess to teach psy- 
choanalysis as this can be learned only by 
long training and study by one already ex- 
perienced in nervous and mental diseases. 
The character of the book permits only a 
minimum of theory and discussion. A brief 
bibliography is appended for those who may 
wish further information on the subject. 

Isapor H. Cortrat. 

Boston, January, 1917. 





CONTENTS 


PAGE 
ETEMERETEPECN I a oe ig Pie me og gee 7 
QUESTIONS AND ANSWERS ON PsycHOANALYsiIs . 18 
Hints For READING i 121 


MMII ee et fe 





WHAT IS PSYCHOANALYSIS? 


ARRANGED IN QUESTIONS AND ANSWERS 
Q. What is psychoanalysis? 


A. Psychoanalysis is the most recent and 
advanced therapeutic procedure for the 
treatment of the neuroses. It is what its 
name implies, an analysis of the mind. 
Other psychotherapeutic methods deal only 
with the superficial manifestations of the 
neuroses and therefore cannot produce a 
fundamental cure. Psychoanalysis con- 
cerns itself primarily with the cause of symp- 
toms, with their real underlying mechanism. 
It not only penetrates into the origin of 
symptoms, but the analysis at the same time 
is the treatment. 

It is a study of man’s unconscious motives 

13 


What Is Psychoanalysis? 


and desires as shown in various nervous dis- 
turbances and in certain manifestations of 
every-day life in normal individuals. It has 
been demonstrated that the manifold symp- 
toms of the neuroses result from unfulfilled 
desires, often extending back to the earliest 
years of childhood. These desires not only 
influence the formation of character traits, 
but likewise are responsible for many forms 
of nervous illness. 


@. Where and under what conditions did 
psychoanalysis originate? 


A. The evolution of psychoanalysis forms 
an interesting chapter in the history of 
medicine. It was in 1881 that Freud, in 
association with Breuer of Vienna, whose 
name is well known for his researches on the 
physiology of the semicircular canals, 
started to treat a young woman who was 
suffering from hysteria. The usual means 

14 


What Is Psychoanalysis? 


were tried in vain, until it was found that 
the facts offered by the patient in expla- 
nation of her condition represented only a 
part of the history. This was not due to a 
deliberate attempt on the part of the patient 
to conceal her medical antecedents, but as 
it later developed, to an unconscious repres- 
sion, because the emotional state which was 
a part of these concealed facts represented 
painful experiences. Finally by a pro-, 
cedure, which later developed into the 
refinements of the psychoanalytic method, 
many hidden experiences of the past with 
their attached emotions were brought to 
light, and it was shown that it was these 
experiences which caused the hysterical con- 
dition. ‘These memories, although buried 
in the unconscious, were active and living 
forces, and only when they were lived over 
again did a cure take place. They were 
not merely forgotten but repressed, al- 
though unconsciously so, and it was only 
15 


What Is Psychoanalysis? 


when this repression was overcome that the 
patient began to improve. 

At first hypnosis was employed to revive 
the forgotten memories, but later it was dis- 
covered that hypnosis was not necessary in 
psychoanalysis, and since then its use has 
been abandoned. In 1895 Breuer and 
Freud published their studies on the mechan- © 
ism of hysteria, in which it was shown that 
the hysterical symptoms arose from reminis- 
cences unknown to and forgotten by the 
sufferer. They demonstrated that the for- 
getting was a purposeful act, in the same 
way that a normal individual conveniently 
“forgets” the unpleasant experiences of 
one’s life. | 

In 1900, Freud published his great work 
on the “Interpretation of Dreams,” and 
there was opened up a new field of investiga- 
tion of the unconscious in both normal and 
sabnormal conditions. Nervous patients 
frequently related strange dreams to him 

16 


What Is Psychoanalysis? 





and it was found that each dream possessed 
a profound personal significance for the 
dreamer, in fact, it was the outgrowth, some- 
times literal, sometimes symbolic, of the 
individual’s unconscious mental life. It 


was definitely proven that every dream was — 


the fulfillment of repressed wishes. Dream 
analysis revealed the mechanism of delu- 
sions, morbid fears, hysteria, fixed ideas and 
compulsive thinking and at the same time it 
provided neurology the most potent instru- 
ment for the removal of these abnormal 
symptoms in the form of what became 
known as the psychoanalytic treatment. 

Thus the fundamental and basic idea of 
Freud’s work is that a large number of 
normal and abnormal mental processes come 
from hidden sources, unknown and unsus- 


pected by the individual. The gulf between : 


normal thinking and abnormal mental states 
has been definitely bridged by psychoanaly- 
sis, for instance, when it is stated, that the 
17 


@ 


What Is Psychoanalysis? 





normal “forgetting” of an unpleasant expe- 
rience is identical but to a more limited 
degree, with the repressions of an hysteric. 


Q. To what other fields of investigation 
has psychoanalysis been applied besides that 
of medicine? 


A. Psychoanalysis has entered many new 
fields of thought. ‘These various principles 
of Freud’s psychology and the psychoana- 
lytic method have been successfully applied 
in not only helping the nervously ill, but the 
same fundamental principles have been used 
to interpret the unconscious sources of wit, 
literary creations, myths, folk lore and the 
slips of the tongue and forgetting of normal 
individuals. It was demonstrated that the 
unconscious mental processes which formed 
dreams were identical with those at work in 
imaginative creations in literature, in wit, 
in the social consciousness and in that folk 

18 


What Is Psychoanalysis? 


spirit from which myths and folk lore are 
elaborated. 

Psychoanalysis is beginning to found a 
new ethics as well as a new psychology, a 
new neurology and a new school of literary 
criticism. It bears the same relation in all 
its principles to the human mind, and to the 
social consciousness, as biology does to the 
organic world. 

Freud’s principal works are his papers on 
hysteria and the psychoneuroses, the three 
contributions to the sexual theory, the work 
on interpretation of dreams,’ the psycho- 
pathology of everyday life, the monograph 
entitled “Totem and Taboo,” the psycho- 
analytic study of Leonardo da Vinci and 
finally the contribution on wit and its rela- 
tion to the unconscious. 

In his three contributions to the sexual 
theory, Freud deals principally with the 


1See the answer to the question on the origin of psycho- 
analysis. 


19 


What Is Psychoanalysis? 


development of the sexual instinct in its 
relationship to repression, both social and 
individual, and the part played by repression 
in the evolution of abnormal mental states.) 

In the psychopathology of everyday life 
it is shown, that the unconscious mental 
mechanism which produces errors in writing 
and speech, the forgetting of familiar names 
and words, slips of tongue and the like, is 
identical with the mental mechanism which 
produces the psychoneuroses. 

The work on “Totem and Taboo” is 
devoted to demonstrating that the individual 
and social defense reactions and the symboli- 
zation of repressed feelings is the same in 
savage man as in the educated individual, 
that is, the taboos of a primitive group are 
essentially identical with the taboos of 
civilized society. 

The study of Leonardo da Vinci is based 
upon a fragment of one of Leonardo’s in- 
fantile memories and by a most ingenious 

20 


What is Psychoanalysis? 


logic, this fragment is utilized to explain 
‘Leonardo’s greatness as an artist and man 
of science and to fathom the mystery of the 
smile of Mona Lisa. 

In the book on wit it is shown that wit and 
laughter are merely methods through which 
the unconscious obtains the greatest amount 
of pleasure within the shortest space of time 
and that the psychological structure of a 
joke very much resembles the psychological 
_ structure of a dream. 

In addition to Freud, other investigators 
have published valuable studies and investi- 
gations on the various medical and cultural 
aspects of psychoanalysis, such as the rela- 
tion between myths and dreams, compara- 
tive mythology, sketches of great artists and 
finally psychoanalytic interpretations of 
complex literary creations, such as Hamlet 
and LadyMacbeth. 


21 


What is Psychoanalysis? 





Q. To whom should the practise of psy- 
choanalysis be limited? 


A. To those thoroughly trained in the 
theory of psychoanalysis and in general 
psychopathology. For an untrained person 
to use psychoanalysis is as much to be 
deprecated as it is for some one to use 
radium who is ignorant of the physics of 
radio-activity or as dangerous as to attempt 
a surgical operation without a knowledge 
of anatomy. | 


Q. What is the attitude of physicians 
trained in nervous and mental diseases, 
towards psychoanalysis? 


A. Some are sympathetic, others antag- 
onize the psychoanalytic movement. On 
reading the criticisms of psychoanalysis, 
however, it will be found that they are 
chiefly remarkable for their complete mis- 

22 


What is Psychoanalysis? 


apprehension of the theories and purposes 
of psychoanalysis. There is a refusal to 
make an honest examination of the subject. 
The chief misunderstandings are along the 
lines of the sexual etiology of the neuroses, 
the manner in which psychoanalysis works, 
transference,! and the technical methods of 
dream analysis and interpretation. 


Q. Can psychoanalysis be harmful? 


A. “Wild” psychoanalysis is a term first 
introduced by Freud and refers to the 
gross errors into which some physicians fall 
who have a hazy idea of the principles and 
teachings of psychoanalysis and attempt to 
apply them in their practise. The serious 
errors which may take place are incorrect 
advice concerning sexual difficulties, an 
over-emphasis on the part of the psycho- | 
analyst on sexual matters, when these are 


1 Explained in the answer to the question on trans- 
ference. 


23 


What is Psychoanalysis? 


shown merely as symbols in the dreams or 
symptoms of the neurosis and the improper 
utilization of the transference. Further- 
more, the mental factor in the neuroses must 
not be overlooked, neither must the analyst 
fall into the error that it is the ignorance of 
sexual matters which needs enlightenment 
and which are producing the neurosis. Inad- 
dition, in the sexual neuroses, such as homo- 
sexuality, the advice which is usually given 
concerning attempts at sexual indulgence, is 
to be strongly condemned, partly for moral 
reasons and partly for the fact that the 
patient does not need such advice, as he is 
fully aware of his difficulties. The analysis 
must be non-personal, the physician must be 
the scientist. During the course of the 
analysis, the reading of psychoanalytic liter- 
ature must be strongly advised against, 
since such reading may produce a mental 
attitude which becomes a strong. resist- : 
ance, 
24: 


What is Psychoanalysis? 


@. What is the cause of certain failures 
in psychoanalysis? 


A. Failures in psychoanalysis are due 
either to bad technique, the lack of trans- 
ference, the strength of resistance.* and 
finally to the type of case which the physi- 
cian is attempting to treat. If the technique 
is at fault, the physician is unable to interpret 
or root out the unconscious factors of the 
neurosis or he may be unable to handle the 
transference or resistances as they should be 
handled. In those cases which do not prog- 
ress to recovery after treatment has been 
carried out for a sufficiently long period, it 
will be found that the failure is due either 
to-— 

1. Impossibility of a complete transfer- 
ence. 

2. The development of resistance due to 


1 Both this term and also “transference,” which are so 
important for psychoanalysis, are explained in the answers 
to the questions dealing with these subjects. 


25 


What is Psychoanalysis? 


some present situation or to a mooring to 
infantile factors. 

3. Inability to break down the disturbing 
unconscious complexes. 

4. A desire on the part of the patient to 
retain the neurosis, since the neurosis acts as 
a withdrawal from a reality which was found 
to be unbearable. In other words, under 
these conditions, paradoxical as it may seem, 
the nervous illness is preferred to mental 
health, since the nervous illness acts as a sort 
of a protector. 

5. In imperfectly selected cases, since 
psychoanalysis should not be used in delir- 
ious states, in persons over fifty years of age, 
since their nervous systems lack a certain 
plasticity, in cases of acute hysteria or in 
severe mental diseases. 


Q. Has psychoanalysis definite laws? 


A. Yes, as definite as the laws of gravi- 
26 


What is Psychoanalysis? 


tation, even though it deals with mental 
instead of physical phenomena. Psycho- 
analysis is both scientific and technical and 
from its data there has developed a new 
science. It has nothing to do with the ordi- 
nary history of the nervous illness as given 
by the patient, for the latter tells his physi- 
cian only his conscious thoughts which are 
revealed either as replies to direct questions 
or as a spontaneous recital of the difficulties. 
Patients too frequently attribute their 
nervous illness to circumstances which act 
merely as precipitating causes and bear no 
relation to the real, underlying motive of the 
illness. ‘The most frequent of these miscon- 
ceptions is attributing their neurosis to over- 
work. It is the reduction of these conscious 
contents of the mind through certain well 
recognized and elaborated technical methods 
to their real unconscious sources in the 
matters of cause and effect, with which 
psychoanalysis primarily deals. 
Qt 


What is Psychoanalysis? 





Psychoanalysis presupposes that there is 
no mental effect without its cause and con- 
sequently nervous symptoms are not chance 
and haphazard products, but are related to 
definite mental processes which are re- 
pressed in the patient’s unconscious. This 
relation of mental cause and effect is called 
determinism. By means of the study of 
dreams and symptomatic actions and some- 
times by use of the association tests, psy- 
choanalysis traces out each symptom in the 
patient’s life history. Sometimes these 
symptoms are found to be deeply buried in 
the earliest years of childhood. It handles 
what are known as the patient’s emotional 
transferences, finds out the cause for any 
resistance to the analysis and finally guides 
the patient to a utilization of his energy 
along more useful social lines than that of 
the neurotic conflict. All this requires the 
expert trained in the theoretical and prac- 
tical aspects of psychoanalysis. 

28 


What is Psychoanalysis? 


Q. Does psychoanalysis apply to the ab- 
normal only? 


A. No, it also gives an insight into the 
workings of normal minds and it may assist 
in changing certain detrimental character 
traits in those who are actually not nervously 


ill. 


Q. Have the methods of psychoanalysis 
been proven practically and theoretically ? 


A. Entirely so, since the practical results 
in the cure of cases of severe nervous illness 
completely harmonizes with the theories 
which lie at the basis of psychoanalysis. 


Q. What types of cases are most suitable 
for psychoanalysis? 


J A. The cases to which psychoanalysis is 
applicable and in which its best results are 
29 


What is Psychoanalysis? 


recorded, consist principally of the severe 
hysterias, the compulsion neuroses and 
anxiety neuroses (formerly grouped under: 
the term of psychasthenia) stammering, 
neurasthenia, sexual neurasthenia, the sex- 
ual neuroses (sadism, masochism, homo- 
sexuality, psychical impotence, etc.), and 
finally certain psychoses, such as mild cases 
of manic-depressive insanity, and in the 
early stages of dementia precox and para- 
noiac states. Psychoanalysis may also be 
of help in cases of kleptomania and in 
determining the underlying motives in 
certain cases of juvenile delinquency when 
these are uncomplicated by mental defect 
or feeble mindedness. 


Q. What class of patients are most diffi- 
cult to treat by psychoanalysis? 


A. Persons over fifty, cases of severe 
stammering and cases of far advanced 
30 


What is Psychoanalysis? 





paranoia or dementia precox. A skeptical 
attitude is no obstacle to a successful psy- 
choanalysis since this skepticism is a form of 
resistance which can easily be overcome. 


Q. Does psychoanalysis tend to produce 
an unhealthy introspection? 


A. On the contrary, its methods are 
directly opposed to those of introspection. 


Q. How does psychoanalysis differ from 
mere introspection? — 


A. Introspection merely records the 
superficial facts of consciousness. It makes 
no attempt to trace the cause of our various 
ideas, neither does it examine the uncon- 
scious contents and motives of the human 
mind. 


Q. Is psychoanalysis a kind of confes- 
sion ? 
31 


What is Psychoanalysis? 





A. A great relief may be gained by a 
secular confession and yet the confession of 
a repressed idea or a secret mental anguish 
does not cure and if improvement takes 
place, it is only temporary. ‘This fact in 
itself invalidates the idea that the beneficial 
effect of psychoanalysis is through free un- 
burdening and mental catharsis. Psycho- 
analysis works through transference, the 
overcoming of resistances, its ability to pen- 
etrate into the unconscious and not to a free 
confession. 


Q. Does not the element of suggestion 
enter imto psychoanalysis; that is, the 
patient’s belief or faith that the method em- 
ployed will cure him? 


A. Under no circumstances. If psy- 
choanalysis is carried out in the manner it 
should be, no explanations or suggestions 
are made to the patient during the course of 

32 


What is Psychoanalysis? 


treatment. Gradually the patient begins to 
see things for himself, begins to understand 
his inner life and actually starts to get well 
or even be cured before he grasps the real 
significance of the psychoanalytic procedure. 
Furthermore, a large percentage of patients 
undertake the psychoanalytic treatment 
with a great deal of skepticism, as they have 
become profoundly discouraged from their 
previous attempts to get well. Psychoanal- 
ysis helps, not because of explanations or 
suggestion, but because it teaches a policy 
of non-resistance towards the neurosis and 
takes the responsibility (transference) of 
the cure. Non-resistance is the first step in 
a psychoanalysis. 


Q. How does psychoanalysis differ from 
suggestion ? : 


A. Those who have first used suggestive 
methods and later substituted psychoanaly- 
33 


What is Psychoanalysis? 





sis for them, have seen the immeasurable 
superiority of the latter over the former. 
Psychoanalysis reaches the fundamental 
difficulties of the nervous illness, whereas 
suggestion merely side tracks it, or covers it 
up for the time being. ‘The most important 
instrument of psychoanalysis is the interpre- 
tations of the dreams, as throwing light 
upon the real unconscious of the nervous 
sufferer, for it is in the unconscious that the 
neurosis has taken its origm. Both the 
dreams and the neurosis originate from the 
same unconscious sources. ‘The method by 
which psychoanalysis works is directly 
opposite to the usual psychotherapeutic pro- 
cedures of hypnosis, persuasion and sugges- 
tion. 

Freud has emphasized the difference 
between psychoanalysis and suggestion, by 
pointing out that the former takes some- 
thing away, that is the power which the 
abnormal mental processes have over the 

34 


What is Psychoanalysis? 





patient, while the latter puts something on, 
in adding the force of the suggestion in 
opposition to that of the neurosis. In the 
most efficacious method of suggestion, that 
is hypnosis, it is well known that it is practi- 
cally impossible to hypnotize certain people, 
while every one can be psychoanalyzed. 
Psychoanalysis does not force anything 
upon the patient which the latter does not 
see for himself and which meets with his 
understanding. ‘Psychoanalysis brings self 
knowledge, although this self knowledge is 
not acquired without a struggle) 


Q. Is the cure wholly due to psychoanaly- 
sis or to other factors such as those who 
manage to get on their feet from work, sug- 
gestion, encouragement or the advice of the 
physician? 


A. The cure is wholly due to psycho- 
analysis, since when patients get well 
35 


: 


What is Psychoanalysis? 


through other methods, the neurosis is likely 
to break out again at some critical emotional 
period. Psychoanalysis removes the cause 
of the symptoms, other methods merely 
change the mental attitude towards symp- 
toms which still persist or at the best, they 
remove only the surface manifestations. 


Q. How does psychoanalysis work? 


A. Principally through transference. 
The analysis attracts to itself the emotions 
which are set free in the course of the analy- 
sis. These emotions are then changed by 
the analytic process, to a new and more use- 
ful form of energy. In the analysis, the 
physician plays the part of the impersonal 
agent which has the specific effect of splitting 
off the energy attached to the repressed ideas 
causing the neurosis and using this energy 
for the purpose of a cure. Psychoanaly- 
sis enables the patient to utilize his re- 

36 


What is Psychoanalysis? 


serve energy for a better purpose than that 
of struggling with the nervous illness. 


Q. What is transference? 


A. Transference is not only the central 
problem of psychoanalysis, but it is the most 
difficult and delicate problem to handle. 
All psychoanalysis proceeds through what is 
called “transference” and it is in the method 
of handling the transferences, that consti- 
tutes the great superiority of psychoanalysis 
in treating the neuroses. Transference 
may be defined as a feeling of acknowledged 
sympathy from the patient to the physician, 
the same as occurs in all lines of medical 
treatment when the patient has confidence 
in his physician. In neurotic patients this 
feeling is much more exaggerated and there- 
fore the sympathetic relation to the physi- 
cian becomes more intense than in patients 
with organic disease. 

37 


What is Psychoanalysis? 


ae 


Transference is therefore not a specific 
result of psychoanalytic treatment, neither 
is transference limited to psychoanalysis, 
but it appears here much more clearly, since 
neurotics have a deeper craving for sympa- 
thy than those who are not nervously ill. 
In psychoanalytic treatment, the trans- 
ference must be delicately handled and not 
at all abused; in fact, the object of the physi- 
cian is to release the patient from the trans- 
ferences which have developed during the 
course of the analysis and break them up. 
It is in the handling of the transferences 
which makes psychoanalysis so difficult, 
because one must be careful that the effect 
of this transference between physician and 
patient does not become permanent, name- 
ly, the dependence on the physician must be 
cut off. In other words, the patient at the 
end of the treatment and when he is cured, 
must be left an independent personality. 
Every successful analysis does this. 'Trans- 
38 


What is Psychoanalysis? 





ference is a barometer of the patient’s 
feelings towards the physician and towards 
the neurosis. All conflicts must be fought 
out in the territory of transference. 

The ethical value of psychoanalysis de- 
pends upon telling a patient the truth and 
maintaining a perfectly sincere attitude. 
The patient must not drive away the trans- 
ference or retain it, but both patient and 
_ physician must treat it as a temporary mani- 
festation occurring during the period of 
treatment. A  neurotic’s interests are 
turned within himself; he cannot be made 
efficient until his interests are projected out- 
side on the practical affairs of life. Trans- 
ference must be handled delicately and 
scientifically, in the same way that a chemist 
handles explosives or like a surgeon cutting 
into delicate nerve tissues. 


Q. How does the transference show it- 
self? 
39 


What is Psychoanalysis? 


A. In the reactions of the patient, in 
dreams and in the rapidity by which the 
symptoms of the nervous illness subside and 
disappear. 


Q. What is resistance? 


A. Resistance is the opposite of trans- 
ference. It is the substitution of a hostile 
feeling for a sympathetic one. Resistance 
may have several sources and like trans- 
ference, is really derived from the patient’s 
unconscious. Resistance arises during the 
unconscious battle of intellect and instinct, 
which is going on in every neurotic. It is 
the force exerted which prevents unwelcome 
and unpleasant thoughts from becoming 
conscious. ‘This process is particularly well 
seen in dreams because what is termed the 
“censor” in dreams, attempts to prevent all 
the dream thoughts from coming out in an 
analysis as so many of these thoughts deal 

40 


What is Psychoanalysis? 





with the deepest recesses of the personality. 
Resistance is the skeleton in the closet which 
plays havoc with the peace of mind. The 
skeleton is the hidden complex, the repressed 
or secret anguish. The attempt to open the 
door on this skeleton is often the source of a 
severe unconscious and even conscious 
struggle in psychoanalytic treatment. This 
struggle is the resistance, and no psycho- 
analysis can be successful until these resist- 
ances are broken down, until the opposite of 
resistance, the transference, is obtained. 
Any obstacle which a patient opposes to 
_his recovery is a form of resistance. Resist- 
ance, like transference, is often indicated in 
the dreams. ‘The patient resists getting 
well, because getting well brings him in 
touch with reality again, whereas the neu- 
rosis, through which he withdraws into him- 
self, offers a refuge from reality. Hence 
the apparently paradoxical statement of 
psychoanalysis becomes clear, when it is 
41 


What is Psychoanalysis? 


stated that the patient gains something by 
his nervous illness and therefore dreads 
getting well. It is probably this form of 
resistance, above all other factors, which 
explains the long duration of nervous ill- 
nesses and the difficulty of successfully 
treating them. In other words, resistance 
is the effort of the patient to defend his 
neurosis from disappearing through psy- 
choanalysis: The reading of psychoan- 
alytic literature in some cases may increase 
the resistance and this kind of self knowl- 
edge tends to lengthen rather than shorten 
the treatment. ‘The resistances of a patient 
should not be criticized as their sources are 
unconscious. ‘The breaking down of resist- 
ances should be left to the physician and 
not attempted by the patient. Confi- 
dence comes when the resistances are over- 
come. 


Q. What is meant by a complex? 
42 


What is Psychoanalysis? 


_ A. An idea with emotions grouped 
around it and attached to it, is termed a 
complex. A complex may consist of pain- 
ful memories which are banished into the 
unconscious, but not really forgotten, since 
such complexes may appear in dreams, 
symptomatic actions or form the underlying 
mechanism of a neurosis. This species of 
forgetting is purposeful, in order to defend 
the mind from painful memories. Such 
purposeful forgetting is termed repression. 
One of the most important of these com- 
plexes is termed the CGidipus-complex. 


Q. What is the CEdipus-complex? 


A. This complex has its origin during the 
earliest years of childhood and consists of an 
over-attachment of the son to the mother. 
In certain children as they develop into 
adulthood, there is a breaking away from 
these infantile attachments. Other children 

43 


What is Psychoanalysis? 





never break away, they never put aside their 
childhood feelings and infantile attach- 
ments, but carry these throughout life re- 
pressed in the unconscious. These children 
become neurotics, since the repressed com- 
plex furnishes the underlying origin of 
many psychoneuroses and abnormal sexual 
inversions. It is such a repressed complex 
which in adults gives rise to dreams of death 
of one of the parents, usually the opposite 
parents to that of the infantile attachment. 
When there is an overattachment of the 
daughter to the father, it is termed the 
Electra-complex. Both terms are taken 
from Greek mythology, as they are identical 
with the family situations of two of the 
greatest Greek tragedies, the Electra of 
Kuripides and the Gidipus Rex of Sopho- 
cles. These two complexes lie at the 
very source of many nervous illnesses. Of 
course it must be emphasized that these 
attachments occur more or less intensely in 
44 


What is Psychoanalysis? 


the lives of all children and it is only when 
they take an exaggerated form or are not 
handled properly, that they become a source 
of danger for the developing child. It is 
this Gidipus complex which frequently lies 
at the basis of homosexuality. 


Q. What is homosexuality ? 


A. This never occurs where the sexual 
development is normal, hence it is not con- 
genital, but_always acquired. It may be 
defined as an abnormal deviation of the 
sexual instinct, in which the attachment is 
for the same rather than for the opposite 
Sex. 


Q. How can parents avoid the dangers of 
over-attachment of their children? 


A. The great danger in all these situa- 
tions is, that the parents never realize it and 
45 


What is Psychoanalysis? 


the child develops into manhood or woman- 
hood and alone feels or knows the situation. 
The condition is really an erotic one and 
hence the large number of individuals who 
develop homosexuality in adult life. Par- 
ents must not allow over caressing from 
their children or show an over-exuberant 
affection for them. ‘The appearance of a 
new child in the family must not be the 
signal for the neglect of the other children, 
as this often leads to secret jealousies. 


Q. What is a symptomatic action? 


_ A. This is an action, such as a slip of the 

tongue or the forgetting of a familiar name 
or even a mistake in writing, which is appar- 
ently due to chance or excused on the basis 
of awkwardness. Analysis however will 
demonstrate that the error is of the nature 
of an unconscious intention. Such symp- 
tomatic actions are frequent in the lives of 

46 


What is Psychoanalysis? 


normal people and still more frequently 
appear in the psychoanalytic treatment of 
neurotics. In both'cases they are produced 
by unconscious thoughts. A symptomatic 
action in a normal individual is really a tiny 
edition of a neurosis, since it has the same 
unconscious background as a neurosis. 


Q. What is repression and how does it 
produce a neurosis? 


A. Repression is a defense of the mind 
under normal and abnormal conditions to 
neutralize or put out of action unwelcome 
and unpleasant thoughts. These thoughts 
are pushed back into the unconscious, 
become repressed and the effort of these 
repressed thoughts to find an outlet, pro- 
duces the nervous illness. The mind 
attempts to find a refuge and free itself 
from mental conflicts through repression. 
A great deal of the “forgetting” which 

A , 


What is Psychoanalysis? 


occurs in normal individuals and in cases of 
nervous illness, is not due to any actual 
decay of memory, as is commonly supposed, 
but to an active repression. Repression 
underlies the forgetting of dreams, those 
losses of memory for limited periods of time 
termed amnesia, somnambulism and also 
the condition known as double or multiple 
personality. The repressed conflict may 
find an outlet and be expressed in what is 
known as projection. This projection may 
manifest itself in peculiar nervous symp- 
toms of a symbolic nature or even as actual 
delusions, hallucinations, fixed ideas or com- 
pulsive thnking. The dream is the most 
common symbolic representation of re- 
pressed thoughts. 


Q. How is the term “sexual” used in 
psychoanalysis? 


A. The term “sex” like “wish” is very 
48 


What is Psychoanalysis? 


broadly used in psychoanalysis. It does not 
‘limit itself to referring to the reproductive 
‘instinct, neither does it mean that the chief 
objective of psychoanalysis is to drag out a 


| 


patient’s sexual experiences. Sexual is not 





the equivalent of sensual, but refers to the 
‘fundamental instinct which lies at the very 
heart of the emotional life, called the libido. 


| 


Q. What is meant by the term libido? 


A. Libido means vital energy or instinct. 
‘It is not always sexual, since the instinct 
‘may be hunger or nutritional, beginning as 
infantile pleasure in nutrition and gradually 
‘shading over into the sexual. Thus hunger 


and sexuality are the two primal human 





instincts, which are the basis, or to use a 
technical term, form the root-complex of 
‘every neurosis. 





Q. What is meant by the “root” of a 
neurosis 2 


49 


What is Psychoanalysis? 


A. The root of a neurosis is a term used 
to denote the fundamental unconscious 
cause of the neurosis and not the conscious 
cause as interpreted by the nervous sufferer. 


Q. What is the psychoanalytic concep- 
tion of sexuality ? 


A. The child brings his sexual instincts 
into the world with him. ‘These instincts 
later may be refined or sublimated into 
higher forms of energy, or if this does not 
take place, various perversions and abnor- 
mal sexual cravings may develop in the 
adult. A child’s sexuality is first turned 
on itself; it is auto-erotic, then it transfers or 
fixes itself to those nearest about him and 
finally, as adult life is reached, it transfers it 
to a person outside the family group. This 
last constitutes what is termed falling in 
love. ‘The sexual components of the child’s 
instincts produce all the neurotic symptoms 

50 


What is Psychoanalysis? 


later in life. It is the unconscious sexual 
desires and not the conscious sexual ideas 
which have the strongest influences over us. 
The word sexual is used in a very wide sense 
in psychoanalysis. The sexual instinct dis- 
plays itself very early in the child, first as 
the sucking or nutritional instinct, secondly 
as the child grows older, the fixation of its 
love on the family group or its nurse and 
thirdly in the sexual changes at puberty. 

In this last period, the auto-erotic char- 
acter of the sexual instinct which charac- 
terized infancy and childhood, is lost and a 
new sexual aim is created accompanied by 
profound physiological changes in the body. 


Q. Does psychoanalysis tend to over- 
emphasize the sexual elements in the neu- 
roses? 


A. Psychoanalysis does not exploit the 
‘sexual experiences of patients, it is not a 
51 


What is Psychoanalysis? 


mere unearthing and exploration of porno- 
graphic material. In fact, if psychoanaly- 
sis be properly carried out, it refers less to 
sexual activities than does the usual medical 
history of an organic illness. I®f the sexual 
appears, it is disclosed because it is present 
in some form or other in every case of nerv- 
ous illness, since no nervous illness can take 
place with a perfectly normal sexual life. 
The sexual aspect of a neurotic’s life is just 
as important as any other aspect. It is not | 
sexuality which injures the hysteric, it is the 
over moral repression of it. If the theory 
of the sexual origin of the neuroses hangs a 
sword over the head of the hysteric as 
claimed by some critics, so does the easily 
proven syphilitic origin of tabés hang a 
sword over the head of the tabetic. 

The problem of sexuality in the neuroses 
is but one aspect of the problem of the mani- 
festation and distribution of that energy 
called the libido. This libido is at the very 

52 


What is Psychoanalysis? 


basis of life and of mental conflicts, at first 
nutritional or self-preservation and in the 
second place, the sexual libido or race per- 
petuation. The word “sexual” is used in a 
very broad manner in the science of psycho- 
analysis, in fact, it has the same broad mean- 
ing as the word “love.” This fact must 
never be lost sight of in psychoanalysis, 
since the use of the word by psychoanalysts 
has been the source of many misconceptions. 
In primitive tribes, it has also been demon- 
strated that hysterical attacks may be 
motivated by an ungratified or a partially 
gratified erotic feeling. 


Q. Is sexual trauma the real cause of a 
neurosis ? 


A. No, because there is scarcely a human 
being who has not had some sexual shock 
and yet only a small percentage of people 
develop a neurosis. If sexual shock were, 
53 


What is Psychoanalysis? 





therefore, the cause of a nervous illness, such 
illnesses would be much more frequent. 
Besides, many of the stories of sexual shocks 
which neurotics relate, are found on careful 
examination to be mere fantastic creations 
and to have never really taken place. Con- 
sequently, during the history of the develop- 
ment of psychoanalysis, the sexual trauma- 
tic theory was soon abandoned. It is now 
evident that the neuroses are due to child- 
hood sexual perversities, the building up of 
unhealthy sexual fantasies and to what is 
termed the fixation of the neurotic’s libido 
upon his infantile past. This is the real 
secret of the neurosis, viz: fantasies which 
have their root in early childhood and which 
attach themselves to some one of the family 
group usually the father or mother, accord- 
ing to the sex of the subject. It is not the 
existence of sexual complexes, but their 
abnormal fixation and over-repression which 
makes the neurotic. 
54 


What is Psychoanalysis? 


@. Since we all have sexual fantasies and 
repressions, why do some escape a neurosis 
and some not? 


A. It all depends on the subject’s manner 
of handling his inner life, as to whether he 
should shut in his personality and become 
introverted and the victim of wish-fulfilling 
fantasies (autistic thinking) or whether he 
becomes active, social and projects his inner 
life on healthy activities, that is, extroverted. 


Q. What are the deviations of the normal 
sexual instinct ? 


A. These are abnormal sexual manifesta- 
tions, such as homosexuality or deviations of 
the sexual object and deviations in regard to 
the sexual aim, such as attaching an abnor- 
mal sexual over-valuation to inanimate 
objects (fetichism) or the relations between 
sexuality and pain (sadism and masochism). 

55. 


What is Psychoanalysis? 


In the unconscious mental life of many 
neurotics, can be found deviations from the 
normal sexual instinct, particularly the 
(Edipus complex. It appears that the 
neurotics are incapacitated by the same 
unconscious sexual complexes with which 
the healthy successfully struggle. 


Q. What can psychoanalysis do for the 
sexual hygiene of children? 


A. The proper manner of training the 
sexual feelings of children, is not to allow 
these feelings to run rampant. The chil- 
dren should be taught to attach and transfer 
their instincts to the higher aims of the 
emotions and intellect, that is, sublimation. 
Such education should be individual, the 
instinct should be trained and led. The 
overcoming of morbid day-dreaming or of 
abnormal shyness or of an excess of self- 
admiration (the so-called narcisstic tend- 

56 


What is Psychoanalysis? 





ency) can do much for the prevention of a 
later neurosis, since these are unhealthy 
instinctive reactions fraught with danger. 


Q. How is consciousness divided? 


A. Into the foreconscious and the uncon- 
scious. 


Q. What is meant by the foreconscious? 


A. Between the realm of the unconscious 
and that of consciousness, lies the forecon- 
scious, which contains the material of recent 
experiences. The foreconscious is_ there- 
fore that part of consciousness just outside 
the focus of attention, but which can be 
easily brought to attention. 


Q. What is meant by the unconscious? 


A. The unconscious is that portion of 
57 


What is Psychoanalysis? 


consciousness of which we are not aware. 
It is the realm of repressed desires and its 
material consists of repressed desires and 
wishes often carried over from early child- 
hood or even infancy. It is a concept or a 
working hypothesis by which certain mental 
facts can be controlled, like the ether of the 
physicists. ‘The unconscious mental life is 
no more a contradiction of terms of psychol- 
ogy, than certain terms such as “‘solid 
solutions” or “invisible light” are in physics. 
It is to be preferred to the term subcon- 
scious, because the latter connotes a spatial 
relationship. ‘The unconscious is the most 
important concept of recent times in the 
realm of mental medicine. It is our histor- 
ical past and as such, in it is preserved the 
primitive traits, emotions, and desires of our 
prehistoric ancestors. The only function of 
the unconscious is wishing or desiring. In 
the unconscious are stored wishes and 
desires, often unethical, which are impossible 
58 


What is Psychoanalysis? 


of fulfillment in reality because of the action 
of the censor of consciousness. These 
wishes are fulfilled in dreams when the 
censor is weak or absent and allows the 
unconscious wishes to slip through in the 
form of a dream. 


Q. What is meant by the censor? 


A. The force which represses unwelcome 
and unpleasant thoughts, for convenience is 
termed the censor. It is really a defense of 
the mind against distressing dreams and 
painful thoughts. It is the censor which 
prevents unconscious thougkts from becom- 
ing conscious. 


@. How does the unconscious manifest 
itself? 


A. In dreams, in symptomatic actions 
like slips of the tongue or pen, neuroses and 
certain mental diseases not of organic origin. 

59 


What is Psychoanalysis? 


@. Can a person know his own uncon- 
scious ? 


A. Only through his dreams and then not 
completely so, since the self analysis of 
dreams can bring up certain resistances, 
hence for the time being blocking all further 
thoughts. Many dreams are symbolic and 
distorted and the symbols and distortions 
are unrecognized by the dreamer. 


Q. What is symbolism? 


A. This is a term used in psychoanalysis 
to express the manner of unconscious think- 
ing in a form in which it would be unrecog- 
nized by consciousness. A dream is often 
symbolic, so is often a nervous symptom, 
when they are expressions of hidden and 
forbidden wishes repressed in the uncon- 
scious. Nervous symptoms are masks be- 
hind which a person takes refuge. The 
symbol is chosen either from the mental 

60 


What is Psychoanalysis? 





content of the individual or it may have a 
racial or a social basis. In unconscious 
thinking, the symbols are often used to 
express sexual concepts, which for moral or 
ethical purposes cannot be expressed liter- 
ally. The sexual symbols of neurotic 
patients are therefore efforts to escape from 
their attachment to the more grossly sexual. 
Symbols are not invented, they are only dis- 
covered. ‘The symbol is not an arbitrary 
choice, but has its source in the unconscious, 
either of the individual or of the race. 
Hence the close resemblance between 
dreams and myths, since the myth is the 
unconscious symbolic expression of the race 
and the dream the unconscious symbol of the 
individual. Symbolism has its origin in the 
remotest ages of the past. The symbolism 
of dreams draws its material from this 
remote ancestry, showing how often the 
dream is merely a fragment of the mental 
life of our prehistoric ancestors. 
61 


What is Psychoanalysis? 


Q. What is the usual history of a pa- 
tient’s efforts to get well before psycho- 
analysis is tried? 


A. There is usually a history of treat- 
ments with tonics and sedatives, the rest cure 
and the searching after an organic cause for 
the neurosis. In some cases suggestion or 
persuasion has been attempted. In the 
carefully recorded histories of nervous pa- 
tients it will be found that all these methods 
have failed because they did not reach the 
cause of the trouble, they attempted to cure 
symptoms without any effort to ascertain 
the origin of the symptoms. 


Q. If a person could not have a complete 
psychoanalysis, but merely told the details 
of his neurosis to the physician, what sort of 
advice ought the analyst to give such a 
person as to the means of making himself 
most comfortable? 

62 


What is Psychoanalysis? 


A. The advice would depend upon the 
nature of the neurosis, the mental attitude - 
of the patient and the actual conflicts which 
had arisen. As a rule the attitude of non- 
resistance is the best advice, since fighting 
the neurosis or attempting to put a morbid 
fear or compulsive thinking out of the mind, 
is likely to render the nervous illness more 
severe, or at the most, nothing is gained. 


Q. What is a mental conflict? 


A. A mental conflict is a battle between 
two opposing groups of ideas, part of which 
are acceptable to the patient and part an- 
tagonized by the patient. These groups of 
ideas may be either conscious or unconscious. 
As a rule conflicts are of a moral nature and 
frequently refer to the grossly sexual char- 
acter of the patient’s thoughts. The at- 
tempt to banish these thoughts produces the 
conflict and the neurosis. Mental dissocia- 

63 


What is Psychoanalysis? 


tion is the result of conflicts. In every 
mental conflict there are two opposing 
forces, the positive or the force of reality, by 
which we come into touch with the external 
world and a negative, through which reality 
is opposed by shutting off the external 
world. It is this last which produces the 
shut-in personality or the negativism which 
is so characteristic of dementia precox. 


@. What is dissociation ? 


A. Dissociation is the method whereby 
the mind gets rid of unpleasant or painful 
repressed complexes. It is really the mind 
defending itself. In dissociation there is a 
splitting of the mental processes, so much 
so, that in cases of obsession or compulsion 
neurosis for instance, the origin of the com- 
pulsive thinking is unknown, since it comes 
from the unconscious and therefore obtrudes 
itself as a foreign body in consciousness. 

64 


What is Psychoanalysis? 


In this splitting of consciousness, the split- 
off complexes may lead an Andependent and 
autonomous existence. 7 ry ‘ 

Q. What is the effect of a Saka psy- 
choanalysis? 


A. A partial psychoanalysis is like an 
unfinished surgical operation. It is not 
radical, it does not cure or even reach the 
real fundamental difficulty. The surface 
symptoms are alone removed. Yet a par- 
tial psychoanalysis may provide sufficient 
self knowledge to enable the sufferer to get 
along more comfortably than if psycho- 
analysis had not been attempted. 


@. Can a person cure himself of a neu- 
rosis by psychoanalytic rules? 


A. No, because his own unconscious is 
not completely accessible to introspection 
65 


What is Psychoanalysis? 


and furthermore, he will tend to build up his 
own resistances and yield to them. 


Q. Why does psychoanalysis require so 
much time? 


A. It does not require any more time than 
the usual methods of sanatorium treatment. 
It has the advantage over the latter, in that 
it leaves the patient free to attend to his 
business or professional interests. 


Q. How long does treatment usually 
take? 


A. This depends upon several factors, 
that is, the age of the patient, the severity 
and duration of the neurosis, the managing 
of the resistances and transferences which 
occur during the course of the treatment 
and finally upon the skill of the psycho- 
analyst in handling the neurotic material. 

66 


What is Psychoanalysis? 





Severe neuroses of long duration and with 
strong resistances may take months to cure, 
the milder neuroses will frequently recover 
within a few weeks. Patients should not 
become discouraged if they do not improve 
as rapidly as they wish. <A slow improve- 
ment may be due to unconscious resistances 
and sufficient time should be given the physi- 
cian to uncover these resistances and elimi- 
nate them. 


Q. Why do some patients get better 
more slowly than others? 


A. Partly because of the nature of the 
nervous illness and partly because of the 
‘unconscious resistance towards treatment. 


Q. What has been the success of psy- 
choanalytic treatment? 





A. Psychoanalysis has been particularly 
suecessful in curing those severe forms of 
67 


What 1s Psychoanalysis? 


nervous illness which have resisted all other 
forms of treatment. In the sexual neu- 
roses, such as homosexuality, the psycho- 
analytic method is the only one which offers 
a hope of cure or even of amelioration of the 
condition. Early or mild cases of dementia 
precox or of mild paranoia, should be 
given the benefit of psychoanalytic treat- 
ment, even if a cure cannot be promised. 
In the psychoanalytic treatment of stam- 
mering, the unconscious difficulties of the 
speech defect may be greatly ameliorated. 
The most gratifying results are obtained 
with cases of hysteria and in the conditions 
of morbid fears. The compulsion neuroses, 
that is cases with obsessions, morbid scruples 
and compulsive thinking are particularly 
favorable for psychoanalytic therapy. Psy- 
choanalysis has also helped those cases 
which show mild depression and also the 
non-organic conditions which have been 
grouped under the name of neurasthenia. 
68 


What is Psychoanalysis? 


The highest percentage of recoveries are in 
cases of hysteria, morbid fears, compulsion 
and anxiety neuroses and in homosexuality. 


Q. What constitutes a cure with the psy- 
_choanalytic treatment? 


A. A nervous illness may be said to have 
recovered if the symptoms disappear and the 
character of the dreams changes to those ex- 
perienced by normal individuals. In the 
anxiety neuroses, the fear should disappear 
during the day and the anxiety dreams at 
night. In the compulsion neuroses, recov- 
ery may be designated as having taken place, 
if there are no further compulsive thoughts 
or acts and if the calamity dreams disap- 
pear.’ In homosexuality, there must be a 
complete disappearance of the homosexual 
erotic feeling during the day and of the 


1 See under compulsion neurosis for a definition of calam- 
ity dreams. 


69 


What is Psychoanalysis? 





homosexual dreams at night. A case of 
dementia precox can be said to have recov~ 
ered, if the patient once more comes into 
complete touch with reality. ‘To cure a case 
of hysteria, it is necessary to remove the men- 
tal conflict which is at the basis of the hyster- 
ical symptoms. ‘The fact that these types of 
cases can be cured through psychoanalysis, 
whereas they were unaffected by other thera- 
peutic procedures, is sufficient to invalidate 
the criticism of those who claim that the case 
could have been cured without psychoanaly- 
sis. 


Q. Does psychoanalysis claim invariable 
successes ? | 


A. No more than any method of medical 
treatment claims invariable successes. Fail: 
ures may be due to lack of transference, poo! 
technique, improperly selected cases or lack 
of sufficient time for treatment. | 

70 : 


What is Psychoanalysis? 


Q. What are the difficultites of psycho- 
analysis? 


A. The great obstacle in all psycho- 
_ analytic treatment is that the patient really 





| does not want to get well. The neurosis 

| acts as a protector from reality, a sort of a 

' shock-absorber from the buffets of life, and 

_ thus a conflict arises between the desire to 

_ retain the neurosis and the desire to get well. 

_ The great fear of every neurotic is the fear 
that he may lose his neurosis. 


Q. What is the effect of psychoanalysis 
.on the neurotic symptoms? 


A. The more recent symptoms disappear 

_ first, while the older symptoms are more dif- 
ficult to remove. As a rule, during the 
course of a psychoanalysis, there is no fur- 
ther development of new symptoms or at 
the most, only transitory new symptoms de- 
velop, which are of the nature of defense 
reactions to retain the neurosis. In homo- 

V1 


What is Psychoanalysis? 


sexuality for instance, the depression and 
anxiety disappear early in the treatment, 
whereas the more fundamental and deeply 
seated symptom of the sexual inversion, is 
more difficult to deal with and is the last to 
disappear. ‘The character of the dreams 
changes, they become more symbolized and 
spiritualized and less grossly sexual during 
the course of a successful treatment. The 
primitive unconscious tendencies become 
‘less in evidence, in other words, the analysis 
raises the unconscious to a higher cultural 
level, it refines and sublimates it. This is 
the educational influence of psychoanalysis 
on an individual. The reserve energy is 
loosened from the neurotic struggles and 
becomes free for constructive living and 
social aims. If the nervous symptoms 
grow worse during the course of the analysis, 
this must be interpreted as due either to the 
resistance or to the course of the disease and 
not to the treatment. 
(2 





What is Psychoanalysis? 


Q. What is meant by sublimation and 
what bearing does it have on recovery? 


A. The term “sublimation” was first in- 
troduced by Freud and was borrowed from 
the terminology of AEE ieee ihe 


freeing (ae ‘paser Bimkieas The process 
of sublimation in psychoanalysis is an un- 
conscious one, that is, it takes place without 
the subject’s knowledge. It is the end re- 
sult of psychoanalysis, since no patient can 
be said to have been cured, until he has suc- 
cessfully sublimated. Sublimation may be 
defined as that unconscious conducting of 
the repressed emotions to a higher, less ob- 
jectionable and more useful goal. It can 
occur only when the libido, through psycho- 
analysis, has been dissociated from the pa- 
tient’s intellectual processes. Therefore, 
_when a patient fights his neurosis or when 
resistance occurs, sublimation becomes diffi- 
73 


What is Psychoanalysis? 


cult because the energy is utilized for un- 
practical purposes. Sublimation is_ the 
capacity for replacement or exchange of the 
original (repressed) aim for a secondary 
social, religious, scientific or artistic aim. 
It is really a transference of basic instincts 
to other interests. 


Q. How can one best sublimate? 


A. Sublimation is more or less of an un- 
conscious process, but it can be hastened by 
assuming a passive attitude towards the neu- 
rosis and so utilizing the energy which was 
formerly wasted in fighting the nervous ill- 
ness, for a more useful purpose. Particular 
attention should be paid to the religious 
tendencies of the patient during a psycho- 
analysis, as some of the most effective sub- 
limations have been along religious lines. 


Q. What is done next after the patient is 
made aware of his buried mental processes? 
14 


What is Psychoanalysis? 


A. Nothing. The psychoanalytic method 
is not merely a diagnostic one but is used 
for the purpose of treatment. When the 
patient is made aware of the buried men- 
tal processes, he is thereby released from 
those intense infantile fixations which are 
at the root of the neurosis and through this 
release, the energies can be utilized for more 
useful social activities. Suggestion merely 
opposes something to the neurosis, while 
psychoanalysis takes away the power that 
the morbid mental processes exert over the 
patient. Psychoanalysis overcomes resist- 
ances, so much so that its chief aim is not 
so much the uncovering of buried or uncon- 
scious mental processes or the knowledge of 
unconscious thoughts, but the overcoming 
of inner resistances. On the force of these 
inner resistances, whether weak or strong, 
depends the rapidity by which the nervous 
symptoms yield to treatment. The patient 
may become aware of the meaning of the 

715 


What is Psychoanalysis? 





symptoms within a short space of time and 
yet the symptoms may continue, thus demon- 
strating that the cure is due to another fac- 
tor and not entirely to self knowledge. 
This factor is the effect of the analysis in 
overcoming the internal resistances. 


Q. How is it possible to tell if a patient 
is cured by psychoanalysis, that the neurosis 
will not again manifest itself at some critical 
period or after an emotional upheaval? 


A. In the first place the unconscious 
sources of the neurosis have been removed 
through psychoanalysis and in the second 
place, the analysis has taught the proper 
method of dealing with actual conflicts. 
The change in the character of the dreams 
often furnishes significant hints concerning 
the future nervous health. 


@. What should be the attitude of the 
psychoanalyst towards the patient? 
16 


What is Psychoanalysis? 


A. The psychoanalyst must have as clean 
a mind as a surgeon has clean hands. The 
attitude of the psychoanalyst should be that 
of the sympathetic physician whose only in- 
terest is his patient’s recovery, and yet at 
the same time that of the scientist who is 
watching and recording a laboratory ex- 
periment. The psychoanalyst must know 
his own individual complexes and resistances 
and must be able to place himself, as it were, 
in the situation of the unconscious of the 
neurosis he is analyzing. 


Q. What should be the mental attitude 
of the person during a psychoanalysis? 


A. Absolute frankness and sincerity, con- 
cealing nothing from the physician. 


Q. What has psychoanalysis to offer, in 
teaching a neurotic to meet his difficul- 
ties ? 

TT 


J What is Psychoanalysis? 


A. The neurosis has its sources in the un- 
conscious and it is therefore something that 
cannot be vanquished by simply fighting it. 
It also shows that the patient has thoughts 
or dreams originating in his unconscious, of 
which he would never be consciously guilty. 
Therefore in compulsive thinking, where for 
instance, the compulsive thoughts are of a 
grossly sexual nature, the patient is not re- 
sponsible for these disagreeable thoughts 
however much his mind may be bombarded 
by them even when he is thinking of some- 
thing else. This latter fact alone shows 
that they have their origin outside of con- 
scious thinking. 


Q. Can psychoanalysis increase the effi- 
ciency of a person who has been made in- 
efficient by a nervous illness? 


A. Yes, by training the patient to direct 
his energy to more useful ends than strug- 
718 | 


What is Psychoanalysis? 


gling with his neurosis or consuming his en- 
ergy on his morbid ideas. 


Q. What does psychoanalysis teach con- 
cerning the mental attitude of a person to- 
ward his neurosis? 


A. The first rule is non-resistance, the 
second that the psychoanalysis takes the re- 
sponsibility of the mental conflicts of the 
nervous sufferer. 


Q. What rules of mental hygiene does 
the psychoanalytic theory teach? 


A. That a person must not fight his 
neurosis whether the neurosis takes the form 
of fears, doubts, compulsive thinking etc. 
since fighting makes the neurosis worse. 
Ihe attitude to be adopted is one of passiv- 
ty and non-resistance. Mental discipline 
merely suppresses the feelings and this sup- 
ression is like putting the lid down on a 

79 


What is Psychoanalysis? 


Jack-in-the-box. When the lid is down, the 
Jack is out of sight, but he is curled up and 





condensed and ready to spring out again with 
full force the moment the pressure of the 
lid (discipline) is removed. What a neu- 
rotic needs is sublimation and a final subli- 
mation must be emotional rather than in- 
tellectual. Psychoanalysis solves the diffi- 
culties of the inner life. ‘The unconscious 
self is the real self which will triumph in the 
final sublimation. The intense love and 
hate of neurotics and their constant crav- 
ings for sympathy are forms of transference 
and consequently symptoms of the nervous 
illness. Such manifestations should not be 
ridiculed but should be taken seriously and 
attempts made to determine their uncon- 
scious sources. 


Q. Is the advice to “dismiss it from your 
mind,” sound advice to give to nervous pa- 
tients? 

80 


What is Psychoanalysis? 


A. No. The physician must be inter- 
ested in the nervous symptoms, he must take 
it for granted that they belong to the pa- 
tient’s life history and therefore have a 
definite meaning or setting in the mental 
life. ‘The patient cannot ignore his nervous 
symptoms, his fears or his obsessions, or dis- 
miss them from his mind, any more than he 
can ignore or dismiss severe pain of organic 
origin. ‘The advice not to worry or to fight 
the unpleasant ideas or nervous symptoms, 
is based upon ignorance or misconception of 
the fundamental nature and motives of a 
nervous illness. To advise travel or dis- 
tractions in amusement is like-wise unavail- 
ing, because this kind of advice presupposes 
that the nervous illness is a senseless group- 
ing of complaints, whereas it is really bound 
up with the sufferer’s wishes and mental 
conflicts and bears an intimate relation to 
the life experiences. Explanation and ad- 
vice however can be made more rational and 

81 


What is Psychoanalysis? 


helpful, if based upon psychoanalytic prin- 
ciples. 


Q. What should be the attitude of psycho- 
analysis to the actual conflicts and diffi- 
culties of life? 


A. There are many external problems in 
life which psychoanalysis cannot adjust, but 
it can adjust the mental attitude towards 
these problems. These actual conflicts and 
problems are those of worry, dilemmas, dis- 
illusionment, etc. Psychoanalysis cannot 
actually eliminate these difficulties, but if the 
real cause of the conflicts is discovered, the 
mental readaptation often follows spontane- 
ously. With an analysis, the real solution of 
the problems becomes clear and the former 
resistance to readjustment overcome. Psy- 
choanalysis points out the solutions from 
within the mind. Simple advice, based upon 
' what psychoanalysis has revealed to both 
82 


What is Psychoanalysis? 


the patient and physician, can often be very 
helpful. Psychoanalysis is often a salvation 
for an existence cramped and difficult to 
live. 


Q. Ought all life worries be psycho- 
analyzed ? 


A. To a certain extent yes, since many 
worries are attributed to sources from which 
they do not actually spring and a brief 
psychoanalysis may help to clear up the real 
situation and furnish better insight into the 
difficulty. 


Q. How can psychoanalytic facts be ap- 
plied to the prevention of the neuroses? 


A. The frequency of nervous diseases is 
due, not so much to the rush of civilization 
_as has been so often claimed, but to the in- 
_jurious overmoral repression of the libido or 

83 


What is Psychoanalysis? 


to the prevailing erroneous ideas concerning 
sexual morality. ‘The instincts should be 
conquered through sublimation and _ not 
through repression. The science of psycho- 
analysis is able to penetrate into the uncon- 
scious sources of this repression in both the 
neurotic and in various types of normal men 
and women. It is able to point out the path 
for the utilization of the repressed energy 
into sublimation. Marriage is not a pana- 
cea for nervousness, since many married 
men and women become nervous and over 
anxious in their attitude towards the strug- 
gles and problems of life. 

The real prevention of the neuroses must 
come through individual analyses and not 
through any general propaganda along the 
lines of mental hygiene, since the latter at 
its best can only indicate collective rules 
which cannot be adapted to the complexities 
of individual minds. It is through the per- 
sonal efforts of parents, educators, clergy- 

84 


What is Psychoanalysis? 


men and also along the lines of sound medical 
advice given to the developing child, that 
neurotic disturbances can be prevented. 
The only or favorite child is particularly 
liable to be spoiled by parental overaffec- 
tion, thus leading to an attitude of self-love 
and self-indulgence, which furnishes the basis 
for many nervous and mental disturbances 
of puberty and adolescence. 


Q. What is the value of psychoanalysis 
in explaining character formation? 


A. The unconscious is that region of the 
mind where the very springs of character 
take their source and which shape the fun- 
damental features of the character of an in- 
dividual. Each individual determines his 
own character and destiny. The charac- 
terological traits of a person are not in- 
herited. The character of a person springs 
deep from his unconscious and is made up 

85 


What is Psychoanalysis? 


either of his original childhood impulses and 
experiences, sublimations of these or reac- 
tions against these. For instance, a timid 
person might by a sort of compensation be- 
come aggressive, a spoiled child who has had 
everything done at his bidding might de- 
velop into an impatient adult. A day 
dreaming child might become taciturn or 
even shut-in in his tendencies or a child with 
too great self-love can never fall in love 
later, or if he does so, it is transitory and 
might lead to social difficulties. All charac- 
ter formation has an emotional rather than 
an intellectual origin. Psychoanalysis is 
able to penetrate to the origin of certain 
character traits and thus be helpful in elimi- 
nating characteristics which may be harmful 
to the individual. 


Q. What is a shut-in personality? 


A. This refers to a peculiar mental make- 
86 


What is Psychoanalysis? 


up out of which cases of dementia precox 
frequently develop. It is characterized by 
a tendency to be anti-social, to live a life of 
reveries and by a disinclination to come into 
touch with reality. This is an unhealthy 
mental attitude and should be strictly com- 
batted if it once appears in a child. 


Q. What is meant by the feeling of in- 
feriority ? 


A. This is a concept introduced to ex- 
plain the make-up of a neurotic individual. 
Fundamentally nervous people are those 
who possess the feeling of inferiority to a 
greater or less extent, such as timidity, lack 
of courage or self-confidence. Such types 
of people attempt to compensate for these 
feelings of inferiority (in the same way that 
a weak heart will compensate) and thus lay 
undue stress upon their defective traits, in 
order to fortify and strengthen them, the 

87 


What is Psychoanalysis? 


coward for instance becoming superlatively 
brave. This latter mental adjustment is 
really a form of sublimation, an attempt to 
conceal the weak points of the personality. 


Q. Can psychoanalysis help to eliminate 
character traits which are detrimental to 
the individual? 


A. It can to a certain extent, particularly 
after the mechanism of the character forma- 
tion has been thoroughly revealed. Anal- 
ysis often shows that character traits of a 
detrimental nature may be due to feelings 
of inferiority, to attempts at repression or 
overcompensation or may arise to cover cer- 
tain trends for the purpose of concealment.) 
The analysis of character is very complex 
and its traits have a root deep in the uncon- 
scious. ‘This shows that character is not a 
matter of will power but of handling one’s 
inner repressions and the reactions against 

88 


What is Psychoanalysis? 





these. ‘Thus a character trait like a nervous 
symptom may be all out of proportion to 
the underlying unconscious source. > 


Q. How is the term “wish” used in psy- 
choanalysis? 


A. The term “wish” is used in a very 
broad sense in psychoanalysis, as indicating 
all desires, yearnings and ambitions. It is 
a dynamic concept, which furnishes the work- 
ing basis for dreams, neurotic symptoms, 
slips of the tongue, mental conflicts and the 
like. 


Q. What is the psychoanalytic theory of 
dreams? 


A. The dream is the true language of the 
unconscious, its means of expression, al- 
though not its only means of expression. A 
dream is always the fulfillment of a wish, 
although that wish may not be clear in the 

89 


i 


- What is Psychoanalysis? 


dream as remembered. The dream as re- 
membered is termed the manifest content. 
The wish is concealed in the underlying 
thoughts which produce the dream. ‘These 
underlying thoughts are termed the latent 
content. Every dream has a deep, personal 
significance for the dreamer, although a 
dream may be thrown into activity by ap- 
parently insignificant thoughts or incidents 
during the day (dream instigators). The 
latent content of the dream, which contains 
the dream wish, may become so distorted 
and symbolized, that the real origin of the 
dream may be unrecognized in the manifest 
content. Occurrences during the day or 
things read, do not cause the dream, they 
merely throw the latent or unconscious 
thoughts into activity. 


Q. How is a dream made? 


A. A dream is made by the large mass of | 
90 | 


What is Psychoanalysis? 


latent thoughts of the dreamer becoming 
condensed into the momentary dream as it 
is remembered on awakening. We are 
aware only of the manifest dream, the latent 
dream thoughts can only be known through 
an analysis of the dream. 


Q. What is the psychoanalytic interpre- 
tation of forgetting? 


A. The forgetting of various places and 
things with which one is familiar is not 
caused by a mere deterioration of memory 
but is an active repression, a purposeful ex- 
clusion of the memory from consciousness. 


Q. Why do we forget dreams so easily? 


A. The forgetting is a purposeful act. 
The dream is “forgotten” because it deals 
with unpleasant material and there is a wish 
to forget it. The forgetting of a dream is 

91 


What is Psychoanalysis? 


not due to our treacherous memories, but is 
really a form of resistance. For instance, 
often in the recital of a dream, a “forgotten 
portion” is suddenly remembered and this 
fragment is usually the most important part 
of the dream. | 


Q. Does a dream as remembered, always 
mean what it says? 


A. No, because the dream as remembered 
may be highly condensed or symbolized or so 
distorted as to give an opposite meaning to 
"what the dream really connotes. The un- 
derlying dream thoughts which produce the 
dream, conceal the dream wish. ‘The mean- 
ing of the dream is hidden in these underly- 
ing dream thoughts. 


Q. Are all dreams wish fulfillments? 


A. Every dream is the fulfillment of a 
92 


What is Psychoanalysis? 


wish. The wish may not be clear in the 
dream as remembered, yet it can always 
be found through a_ psychoanalysis in 
the latent content of the dream. In the 
_ dreams of children the wish in the dream is 
more clearly indicated than in the dreams of 
adults. In adults the wish is in the latent 
content and not in the manifest content of 
the dream. | 


Q. From what sources do the wishes in 
dreams originate? 


A. 1. Wishes that arise during the day, 
but are unfulfilled and so are fulfilled in the 
dream, such as dreams of children, who fre- 
quently dream of dainties or play activities 
denied them during the day. 

2. The wish may come up during the day 
but may be rejected and repressed, such as 
feelings of hatred or desires for revenge. 
These wishes are then completely fulfilled 

93 


What is Psychoanalysis? 


only in the dream, because the ethical ful- 
fillment is impossible in reality. 

3. Wishes or desires may arise during the 
night while sleeping, such as thirst and a wish 
for water. These wishes are usually ful- 
filled by a dream of drinking, in order to pre- 
vent the sleeping subject from awakening. 

4. Wishes deeply -buried in the uncon- 
scious and carried over from early child- 
hood. This explains why we so often dream 
of injuring those relatives who are near and 
dear to us. 


Q. Is the wish fulfillment always clear in 
the dream? 


A. No, because the wish may be highly 
disguised or distorted and can only be de- 
termined through an analysis of the dream. 


Q. How is the fact explained that we 
sometimes dream of the death of one of our 
94 


What is Psychoanalysis? 


parents, whom we certainly do not con- 
sciously wish dead? 


A. It means that the wish existed at one 
time in very early childhood and for ethical 
reasons was repressed. The meaning of 
death to a child has a different connotation 
from death to an adult, since the former de- 
notes merely out of the way for the time be- 


ing. 
Q. What is the function of dreaming? 


A. To protect sleep from the mass of 
latent thoughts by making these thoughts 
momentary and unrecognizable by the 
sleeper. ‘The only type of a dream which 
disturbs sleep is a nightmare. 


Q. What is a nightmare? 


A. A nightmare is an anxiety dream. 


95 


What is Psychoanalysis? 


An anxiety dream is very difficult to ex- 
plain, since the element of fear in such a 
dream seems to contradict the theory of wish 
fulfillment and protection of sleep. ‘This 
contradiction is more apparent than real 
however. An anxiety dream means that we 
have suppressed the desire for certain for- 
bidden pleasures in the unconscious. ‘The 
suppression produces conflict and pain, the 
pleasure is throttled and when it escapes it 
assumes the character of the suppressed 
pain. 


Q. What is the place of the dream in 
psychoanalysis? 


A. Dream analysis can show a man’s 
latent possibilities and his real ambitions and 
desires. It portrays the psychological situa- 
tion of the unconscious and hence dream an-— 
alysis is an absolute necessity in psycho- 
analysis. Dream analysis can never become 

96 


What is Psychoanalysis? 





mechanical, although it is based on certain 
technical rules. 


Q. How do the dreams bring out certain 
things, such as concealed facts unknown to 
the dreamer? 


A. A dream is the product of the uncon- 
scious, consequently a dream is an index of 


unconscious thinking. The free associa- 


tions of the various elements of dreams fur- 
nish the material out of which the dream is 
made. Much of this material consists of 
repressed desires which were unknown to the 
dreamer until the dream analysis was made. 


Q. How does dream analysis help the pa- 
tient ? 


A. Through the dreams, the analysis is 
able to determine the unconscious desires 
and wishes, the conflicts, transferences and 


various resistances of the patient. It gives 


97 


What is Psychoanalysis? 





an insight into the unconscious mental life 
and thus unravels the mechanism of the neu- 
rosis and the repressed material out of which 
the neurosis is constructed. Sometimes one — 
dream will be found to contain the secret of 
the neurosis. An elaborate dream is often 
of less value than a short one, since the lat- 
ter often reaches to unconscious levels in 
which lie the very roots of the neurosis. 
The first dream of the analysis is very 1m- 
portant, although in many cases the most 
difficult to analyse completely, since it often 
contains the entire mental attitude towards 
the psychoanalytic procedure. The same 
theme may appear with many variations and 
symbols in different dreams. 


Q. What is the practical value of dream 
analysis? 


A. It gives an insight into the uncon- 
scious mental life of individuals and of so- 
98 


What is Psychoanalysis? 


cial groups and thus helps in determining 
the real motives of men and women and of 
society in general. It has also thrown light 
on comparative mythology and shown that 
the psychological structure of a myth is the 
same as that of a dream. Dream analysis 
also helps in determining the wishes, resist- 
ances, mental conflicts, and jealousies of 
normal individuals. 


_Q. If a person does not dream, how is it 
possible to penetrate the unconscious? 


A. Every one dreams, although in some 
persons the resistance is so great, that the 
dreams are speedily forgotten on awaken- 
ing. If there is an absolute insistence that 
no dreams took place, then it is necessary to 
watch the symptomatic actions or even to 
utilize artificial dreams, for the penetration 
of the unconscious. 


99 


What is Psychoanalysis? 





Q. What is an artificial dream? 


A. This is a dream which a person con- 
sciously makes up when requested to fabri- 
cate what he would consider to be a genuine 
dream. Artificial dreams contain the same 
distorting mechanisms and have the same 
unconscious mental processes as genuine 
dreams. | 


Q. What is meant by typical dreams? 


A. Such dreams as of being insufficiently 
clothed, flying, of the death of a near and 
dear relative, such as a parent. They are 
called typical dreams because nearly every 
one has dreamed of them in much the same 
manner. ‘The inner meaning of such dreams 
arises from emotions which are common to 
the entire human race. They consequently 
have the same significance in the case of 
every dreamer. 

100 


What is Psychoanalysis? 


Q. Can a dream be interpreted arbi- 
trarily ? 


A. Only certain typical dreams can be so 
interpreted and then only in a superficial 
manner. A complete dream interpretation 
requires active codperation and a knowledge 
of the person’s life interests. 


Q. Can every dream be interpreted and 
analyzed ? | 


A. No, because in some dreams the resist- 
ance is so strong and the material out of 
which the dream is woven lies in such deep 
strata of the unconscious, that a complete 
analysis is impossible. This difficulty is due 
to the fact that the inner resistances inter- 
fere with the free associations which are nec- 
essary for the analysis of the dream. If 
these resistances can be Overcome, the dream 
can then be analyzed, for instance, it often 

101 


What is Psychoanalysis? 


occurs during the course of psychoanalytic 
treatment, that a dream which it was impos- 
sible to analyze early in the treatment, be- 
comes easily interpreted later. 


Q. Can a person analyze his own dreams? 


A. Only to a certain extent and then only 
simple wish dreams, typical dreams or those 
in which the symbols are distinct. In 
self-analysis of dreams, the interpretation 
usually given is the one desired and not the 
real analysis, since the resistance prevents an 
insight into the actual meaning of the dream. 


Q. Can dream interpretation also be ap- 
plied to the workings of normal minds? 


A. Yes, since the dreams of normal indi- 
viduals often show their repressed wishes, 
desires, ambitions, jealousies and mental con- 
flicts. 

102 


What is Psychoanalysis? 


Q. Does heredity have anything to do 
with a neurosis? 


A. Not directly, only in the sense of an 
hereditary predisposition. A neurosis is 
neither inherited nor transmitted, but arises 
solely from the emotional conflicts of an in- 
dividual. If we were satisfied with pigeon- 
holing the neuroses as hereditary, it would 
have barred the investigation of the cause of 
the neuroses and stopped all efforts at treat- 
ment. A neurosis is an acquired character- 
istic and such a character cannot be inherited. 
What is so often called heredity in children 
is merely imitation of their elders. 


Q. Why is it that a nervous illness seems 
to break out suddenly at some critical emo- 
tional period? 


A. Because a new adaptation, a kind of 
- anew mental adjustment, becomes suddenly 
103 


What is Psychoanalysis? 


necessary. ‘Then the neurosis breaks out, 
not because of an emotional shock or from 
fatigue, but from the emotional trends which 
the patient for years has repressed in his un- 
conscious. In other words, the neurotic has 
suddenly become the victim of a regression 
or return to his infantile fixations. ‘The fa- 
tigue or emotional upheaval or anxiety 
which often precedes such a nervous break- 
down, is not its actual cause, but merely its 
instigator. We are all in danger of a neu- 
rosis to a limited degree, because when new 
difficulties arise, we tend to minimize them 
by retiring within ourselves. In this mental 
attitude, difficulties are temporarily re- 
moved, but the attitude itself constitutes the 
neurosis. In other words, a neurosis means 
that the patient wishes to avoid some task or 
get away from some new problem of adapta- 
tion. 


Q. What is the feeling of unreality? 
104 


What is Psychoanalysis? 


A. This feeling of the surroundings ap- 
pearing unreal is a very frequent symptom 
of many forms of nervous illness. Its 
origin is very complex. Briefly, it arises 
because the subject finds reality too painful 
to bear and he prefers to live in a world of 
his own ideas rather than in the world of 
physical reality. This dominating by the 
unreality feeling is an unconscious mental 
process rather than a conscious and deliber- 
ate act. It is a condition which can be 
greatly helped and in many cases cured by 
psychoanalysis. 


@. Can overwork produce a nervous 
illness? 


A. Overwork can never produce a neu- 
rosis unless the soil has already been pre- 
pared for it. Overwork merely reduces the 
resistance, enabling the neurosis to make its 
appearance. It does not produce the neu- 

105 


What is Psychoanalysis? 


rosis because the symptoms are all out of 
proportion to the actual physical fatigue 
which antedated the so-called “breakdown.” 
Furthermore the fatigue of which so many 
nervous patients complain, is false fatigue 
and not a genuine physical fatigue. For this 
reason, such patients feel more tired in the 
morning and the fatigue actually wears off 
during the day’s activities and this also ex- 
plains why such patients fail to improve with 
rest, 


@. What is a nervous breakdown from a 
psychoanalytic standpoint? 


A. Neurasthenia or a nervous breakdown 
cannot be explained on a purely organic 
basis. The neurasthenic condition really 
consists of unconscious desires striving for 
expression. Many so-called “nervous 
breakdowns” are. really eases of mild 

106 


What is Psychoanalysis? 


periodic depression or of various psycho- 
neuroses. 


Q. What can psychoanalysis do for these 
nervous breakdowns? 


A. In many cases it can prevent the 
recurrence of a periodic nervous breakdown 
by eliminating its unconscious sources or the 
breakdown may be cured through psycho- 
analysis. 


Q. Is it necessary to dig into and unravel 
all the fantasies which have become re- 
pressed in the patient’s unconscious? 


A. Yes, because the energy which the 
patient needs for the restoration to and the 
maintenance of his mental health, is attached 
to these repressed fantasies. By dragging 
the fantasies into consciousness they become 
detached from the libido and the reserve 

107 


What is Psychoanalysis? 





energy of the patient can then be utilized 
to more useful ends, or in technical terms, 
become sublimated. ‘Thus psychoanalysis 
helps the patient to adequately meet the 
tasks of life and in a moral sense, it reédu- 
cates and reconstructs him. ‘The real cure 
in psychoanalysis comes from within, for 
after all the conscious material has been 
thoroughly considered, the dreams are next 
investigated, as these furnish the uncon- 
scious material which is producing the neu- 
rosis. 


Q. What is hysteria? 


A. Hysteria is due to ideas which are out 
of harmony with the rest of the personality. 
These ideas are repressed. and this repres- 
sion is at the basis of all hysterical manifes- 
tations. It is the repression which causes 
the dissociation of hysteria. The repressed 
ideas may be converted into the peculiar 

108 


What is Psychoanalysis? 


mental states and conditions of forgetful- 
ness (amnesia) of hysteria or they may be 
converted into the physical symptoms of 
hysteria, such as paralysis, blindness, losses 
of sensation, feelings of unreality, etc. 
Hysteria is, therefore, the effort of the 
human mind to disguise its unpleasant 
thoughts and experiences, and as_ such, 
hysteria always represents a mental conflict. 


Q. What is anxiety hysteria? 


A. This is a form of nervous disease 
which is associated with various morbid 
fears. With these fears there is associated 
the usual psychological accompaniments of 
the emotion of fear, such as difficulty of 
breathing, palpitation of the heart, trem- 
bling and sometimes disturbances of the 
stomach and intestines. Many so-called 
nervous children are sufferers from anxiety 
hysteria. 

109 


What is Psychoanalysis? 


Q. What is an anxiety neurosis? 


A. This is sometimes difficult to distin- 
guish from anxiety hysteria. Many cases of 
stammering and so-called neurasthenia are 
really cases of an anxiety neurosis. 


Q. What is the psychoanalytic theory of 
stammering and what can psychoanalysis 
do for the treatment of stammering? 


A. Stammering is a form of an anxiety 
neurosis. ‘The motivating mechanism which 
causes stammering is unknown to the suf- 
ferer, that is, it is unconscious, the only con- 
scious reaction being that of anxiety, fear, 
and difficulty of talking. The distributing 
element in stammering is mental and not 
physical, it is more than a mere affection of 
speech. The attempt to repress from con- 
sciousness into the unconscious, certain 
trends of thought or emotions, is the chief 

110 


What is Psychoanalysis? 


mechanism in stammering. The repressed 
thoughts, because of fear of betrayal, come 
into conflict with the wish to speak and not 
to betray, and hence the stammering arises. 
The cure for stammering can be attained 
only through an exploration of the uncon- 
scious and a complete breaking down of 
those resistances which in early childhood 
produced the stammering. Phonetic or 
speech training can accomplish but little or 
at the most can produce only temporary 
results in stammering. It is necessary to 
know all the stammerer’s fears and their 
origin before sound advice can be given con- 
cerning the mental attitude towards the 
difficulties of talking. 


Q. What is a compulsion neurosis? 


A. Cases with compulsive thinking, such 
-as obsessions and doubts, constitute a com- 
-pulsion neurosis. It was formerly termed 

111 


: 





What is Psychoanalysis? 


psychasthenia. A compulsion neurosis is a 
very complex disturbance and its ramifica- 
tions in the mental life are deep and far 
reaching. Its mechanism is probably a 
transferred self-reproach from something 
which has been repressed into the uncon- 
scious. This is particularly shown by the 
frequent appearance of what may be termed 
“calamity dreams.” ‘These are types of 
dreams in which harm or evil appears to 
be happening to others. Such wishes 
are strongly repressed in the unconscious 
and consequently are only revealed in the 
dream. 


Q. What is the psychoanalytic interpreta- 
tion of kleptomania? 


A. In a case of kleptomania, if feeble- 
mindedness, and actual insanity can be elim- 
inated, the kleptomania is very likely a form 
of a compulsion neurosis. 

112 


What is Psychoanalysis? 





Q. What is psychoanalysis able to do for 
cases of manic depressive insanity? 


A. It can be very helpful. Many of the 
mild cases of manic-depressive insanity, 
which are termed cyclothemia, are in reality 
cases of anxiety hysteria. Their only re- 
semblance to the manic-depressive group 
is in their periodicity. Many cases of 
depression and even of exaltation, will be 
found on analysis to be the patient’s method 
of getting away from reality or in reaction 
to unconscious emotional strain. The de- 
pression and excitement arise from mental 
conflicts. The depression is an overwhelm- 
ing of the mind by repressed emotions, the 
excitement is an effort to keep the painful 
ideas out of the mind. Many cases of 
periodic neurasthenia or mild periodic de- 
pression can be distinctly helped or even 
absolutely cured through the analytic inves- 
tigation of the underlying cause of the 
113 


' 
| 






What is Psychoanalysis? 


mental disturbance, since many of these 
cases are really due to a lack of emotional 
adaptation. Cases with periodic depres- 
sion often show a constitutional tendency to 
depressed states and it is here that psycho- 
analysis may make a change for the better. 


Q. What can psychoanalysis do for 
alcoholism ? 


A.. Provided there are no evidences of 
alcoholic mental deterioration, psychoanaly- 
sis can help, and in many instances cure, 
cases of periodic alcoholism. The drinking 
habit is due to complex mental factors, which 
are merely instigated by temptation and 
opportunity. The real underlying cause of 
a sudden alcoholic bout is unknown to the 
sufferer. Psychoanalysis is often able to 
determine the cause and thus remove it. In 
many cases, periodic alcoholism is due either 
to an effort to get away from reality or in 

114 


What is Psychoanalysis? 


reaction to suppressed sexual desires. The 
impelling cause of many cases of alcoholic 
indulgence or the compulsive, irresistible 
feeling to drink, lies in the unconscious. 


Q. Is it possible to help a case of dementia 
precox by psyehoanalysis? 


A. Only early, mild or latent cases of 
dementia precox are suitable for psycho- 
analytic treatment. Even if it is impossible 
to cure a case of dementia precox, many of 
the symptoms may be largely relieved. 
Furthermore, a psychoanalytic investigation 
of a dementia precox patient will often 
furnish information, concerning the prob- 
lem of regulating the life interests. De- 
mentia precox may be interpreted as a 
functional mental disturbance, a form of 
dissociation of the personality, with a with- 
drawal of personal interests from reality in 
much the same way as hysteria, but of a more 
intense form. 

115 


What Is Psychoanalysis? 


Q. How does the usual medical history of 
a nervous illness differ from a psychoanaly- 
sis? 


A. The usual accounts given by patients, 
of their nervous illness, do not reproduce the 
entire story, no matter how honest the 
individual may be in his attempt to relate all 
the facts, or how keen the memory in stating 
the details. Under these conditions only the 
superficial data are given, since conscious- 
ness conveniently “forgets” those incidents 
which are disagreeable to the personality and 
represses these into the unconscious. These 
repressed memories can be withdrawn from 
the unconscious only by the work of psycho- 
analysis. 


Q. What is the ethical value of psycho- 
analysis? 


A. Psychoanalysis teaches that the uncon- 
116 


What Is Psychoanalysis? 


scious gets its gratification through a sym- 
bolic outlet, either in the form of dreams or 
of neurotic symptoms. Repression is the 
most important factor in our civilized life. 
It keeps individuals from doing harm even 
if they have evil thoughts. ‘The repressed 
feelings however are not lost; there is no 
waste of energy, since these feelings are sub- 
limated or utilized for a higher and more 
useful purpose. Psychoanalysis encourages 
a more honest form of thinking, both in in- 
dividuals and in social groups. It gives an 
insight into the real workings of our minds 
and our feelings and teaches us what we 
really are. ‘There is a constant tendency in 
all of us to a self-deception, we conceal our 
real thoughts and feelings through illogical 
deductions or in obedience to what we term 
moral conduct. This process is termed 
rationalization. Psychoanalysis penetrates 
into the unconscious motives of our thoughts 
and actions, and shows, how without self- 
117 


What Is Psychoanalysis? 


deception, we can best utilize our inner feel- 
ings for the conduct of life. 


Q. What bearing has psychoanalysis on 
education ? 


A. The purpose of psychoanalysis is to 
utilize the energy of an individual so that it 
will find a natural outlet. As such, psycho- 
analysis is educational in its scope, since it 
tends to utilize for practical purposes all 
that is best in an individual. ‘The earliest 
years of childhood are very important for 
good health and sound character and it is in 
these early years that education based on 
psychoanalytic principles, is most effective 
for the prevention of a future nervous illness 
or the formation of undesirable character 
traits. Many of the bad habits of childrenz 
such as lying or stealing, may be early forms 
of a future compulsion neurosis. Children 
Should be encouraged to find suitable outlets 

118 


What Is Psychoanalysis? 


for their interests, otherwise their interests 
may be turned inward on themselves, lead- 
ing to those day-dreams and mental con- 
flicts, which so often produce a neurosis. 
Particularly to be avoided, is the impressing 
of children with feelings of guilt, shame or 
terror, by insistence on punishment, or 
frightening the child with bogies. 


Q. What is the future of psychoanalysis? 


A. The future of psychoanalysis depends 
upon the improvement in its technique, the 
general cultural advance of psychoanalytic 
investigation, careful statistical studies of 
_ the effect of the method by different workers 
in the field and finally making physicians 
more familiar with the theory and practise 
of psychoanalysis. It will aid in the pre- 
vention of neuroses by giving an insight into 
the real mechanisms which produce nervous 
_ breakdowns, such as, that nervous invalidism 
119 


What Is Psychoanalysis? 


is not due to overwork, but to repressed 
emotions and unsatisfied instincts. The 
psychoanalytic method of investigating un- 
conscious mental processes is full of promise 
for the future. 


120 


HINTS FOR READING 


K. ABRAHAM—Dreams and Myths—1913 
A contribution to comparative Mythology 
showing that the same elements enter into the 
structure of both dreams and myths. 
ALFRED ADLER—The Neurotic Constitution 
—1917 
A psychological analysis of the mental 
make-up of nervous sufferers. 
A. A. BRILL Psychoanalysis—1913 
A series of papers on the theories and the 
practical application of psychoanalysis. 
ISADOR H. CORIAT—Abnormal Psychology— 
1914 
An outline of the entire field of Abnormal 
Psychology. 
The Meaning of Dreams—1915 
A general outline of the meaning of dreams, 
their relation to the unconscious and the prob- 
lems of psychoanalysis. 
The Hysteria of Lady Macbeth—1912 
A psychoanalytic interpretation of the 
character of Lady Macbeth. 
Psychoneuroses Among Primitive Tribes—Jour- 
nal of Abnormal Psychology—1915 
121 


What Is’ Psychoanalysis? 


A study of hysterical attacks in the primi- 
tive men of the Fuegian Archipelago. 
S. FERENCZI—Contributions to Psycho-Analy- 
sis—1916 
A series of papers dealing in a highly tech- 
nical manner, with various aspects of psy- 
choanalysis. 
SIGMUND FREUD—The Interpretation of 
Dreams—1914 
The fundamental work on psychoanalysis 
in which the mechanism of dreams and the 
functions of the unconscious are discussed in 
great detail. 
Three Contributions to the Sexual Theory— 
1912 
The entire question of sexual development 
is discussed from a new and broader view- 
point. 
Leonardo da Vinci—1916 
A psychoanalytic character study of the 
great Italian painter. 
Wit and its Relation to the Unconscious—1916 
A study of the mental process of wit and 
laughter. 
The Psychopathology of Everday Life—1914 
A study of the unconscious actions of nor- 
mal persons. 
The Origin and Development of Psychoanalysis 
—1910 : 
122 


What Is Psychoanalysis? 





Five Lectures delivered at the Twentieth 
Anniversary of Clark University, and giving 
a history of the psychoanalytic movement by 
its founder. 
BERNARD HART—The Psychology of Insan- 
tty—1912 
A psychoanalytic study of mental dis- 
eases. 
E. HITSCHMANN—Freud’s Theories of the 
Neuroses—1913 
The significance of psychoanalysis for 
medicine. 
EDWIN B. HOLT—The Freudian Wish—1915 
The relation of psychoanalysis to ethics 
with a discussion of the function of the “wish” 
as a key to the mind. 
ERNEST JONES—Papers on Psychoanalysis— 
1913 
A collection of papers on the applications 
of psychonalysis. 
C. G. JUNG—Psychology of the Unconscious— 
1916 
A contribution to the history of the evo- 
lution of thought on the basis of the analy- 
sis of unconscious thinking. 
Analytical Psychology—1916 
A collection of papers previously published, 
on the various therapeutic aspects of psycho- 
analysis. 


123 


What Is Psychoanalysis? 


OSKAR PFISTER—The Psychoanalytic Method 
—1917 
The application of Psychoanalysis to the 
education of children. 

J. J. PUTNAM—Human Motives—1915 

A study of human motives from a psycho- 
analytic viewpoint. 

O. RANK AND H. SACHS—The significance of 

Psychoanalysis for the Mental Sctences— 

1916 

A contribution to the cultural aspects of 
psychoanalysis. 

WM. A. WHITE—Mechanisms of Character 

Formation—1916 
Human character interpreted according to 
psychoanalytic principles. 

Among journals, may be mentioned the Psycho- 
analytic Review, published quarterly, 
and the Journal of Abnormal Psychol- 
ogy, published bi-monthly. The former 
is devoted exclusively to the various 
medical and cultural aspects of psycho- 
analysis; the latter contains a large num- 
ber of psychoanalytic articles. 





124 


INDEX 


Alcoholism, 114 

Anxiety hysteria, 109 
Anxiety neurosis, 110 
Autistic thinking, 51 


Censor, 59 

Character formation, 85 

Character traits, effects of 
psychoanalysis on, 88 

Children, sexual hygiene of, 
56 

Complex, 42 

Compulsion neurosis, 111 

Confession, 31 

Consciousness, divisions of, 
57 

Cure, 35, 69, 76 

Cyclothemia, 113 


Dementia, preecox, 115 
Determinism, 28 
Dissociation, 64 
Dream analysis, value of, 98 
Dreams, artificial, 100 
construction of, 90 
Dreams of death, 90 
Dreams, forgetting of, 91 
function of, 95 
interpretation of, 101, 102 
lack of, 99 


Dreams 
96, 97 
Dreams, remembering of, 92 
self-analysis of, 102 
source of wishes in, 93 
theory of, 89 
typical, 100 
Dreams as wish-fulfillments, 
92, 94 


in psychoanalysis, 


Education and _ psychoanal- 
ysis, 118 

Efficiency, 78 

Electra-complex, 44 

Ethics, 116 


Fetichism, 55 

Foreconscious, definition of, 
57 

Forgetting, 91 


Heredity, 103 
Homosexuality, 45 
Hysteria, 108 


Illness, history of, 62 
Inferiority feeling, 87 
Introspection, 31 


Kleptomania, 112 


125 


Index 





Leonardo da Vinci, 20 
Libido, 49 


Manic-depressive 
113 
Masochism, 55 
Mental conflicts, 63, 82 
Mental hygiene, 45, 79, 80 


insanity, 


Narcissism, 56 
Nervous breakdown, 106, 107 
Nervous illness, history of, 
116 
Neuroses, prevention of, 83 
Neurosis, outbreak of, 103 
overwork in, 105 
root of, 49 
sexuality in, 51 
Night mares, 95 
Normal minds, 29 


CEdipus-complex, 43 
Overwork, 105 


Projection, 48 
Psychoanalysis, attitude to- 
wards, 22 
attitude during, 77, 79 
definition of, 13 
difficulties of, 70 
effects of, 71 
failures in, 25 
future of, 119 
harm of, 23 
laws of, 26 
origin of, 14 
partial, 62, 65 
practise of, 22 


proof of, 29 

scope of, 18 

success of, 67, 70 

teachings of, 77 

time required for, 66 
Psychoanalyst, 76 
Psychopathology of everyday 

life, 20 


Rationalization, 117 
Repression, 47 
Reserve energy, 36 
Resistance, 40 


Sadism, 55 

Self-cure, 65 

Sex, definition of, 48 

Sexual fantasies, 55 

Sexual instinct, deviations of, 
55 

Sexual theory, 50 

Sexual trauma, 53 

Sexuality, psychoanalytic 
conception of, 50 

Shut-in personality, 86 

Stammering, 110 

Sublimation, 73, 74 

Suggestion, 32, 33 

Symbolism, 60 

Symptomatic action, 46 


Taboo, 20 
Transference, 37, 39 
Treatment, 29, 30, 66, 67 


Unconscious, definition of, 57 
self-knowledge of, 60 
manifestations of, 59 


126 


Index 





Wish, definition of, 89 Wit, 21 
‘Wishes in dreams, 93 Worry, 83 
Wish-fulfillments in dreams, 

92, 94 


127 














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